Uterus: Visualises the size, shape, and position of the uterus. It can detect abnormalities such as fibroids (non-cancerous growths), polyps (abnormal tissue growths), and structural defects like septate uterus.

Ovaries: Pelvic ultrasound assesses ovarian size, shape, and the presence of cysts (fluid-filled sacs) or tumours. It helps in diagnosing conditions like ovarian cysts, polycystic ovary syndrome (PCOS), and ovarian cancer.

Fallopian Tubes: The ultrasound can evaluate the patency (openness) and condition of the fallopian tubes. It helps in diagnosing conditions such as tubal blockages or scarring, which may affect fertility.

Endometrium: This is the lining of the uterus. Pelvic ultrasound can measure the thickness of the endometrium and detect abnormalities such as endometrial polyps or hyperplasia (thickening).

Bladder: While not directly part of the reproductive system, the bladder is often included in pelvic ultrasound to assess its size, shape, and the presence of abnormalities such as bladder stones or tumours.

Pelvic Fluid: The ultrasound can detect abnormal fluid collections within the pelvic cavity, which may indicate conditions such as pelvic inflammatory disease (PID), ovarian cyst rupture, or ectopic pregnancy.

Pregnancy: Pelvic ultrasound is crucial for monitoring pregnancies. It can confirm the presence of a viable pregnancy, determine gestational age, assess foetal growth and development, detect multiple pregnancies (twins, triplets), and identify any potential complications such as ectopic pregnancy or placental abnormalities.

Transabdominal Ultrasound: Uses a transducer on the abdomen with gel to scan pelvic organs like the uterus, ovaries, and bladder from outside the body. Its effective for initial screenings and detecting conditions like cysts or tumours.

Transvaginal Ultrasound: Involves a smaller transducer inserted into the vagina to obtain close-up images of pelvic structures. It provides clearer views of the uterus, ovaries, and fallopian tubes, useful for diagnosing conditions like fibroids and monitoring pregnancies.

Pelvic Doppler Ultrasound: Assesses blood flow in pelvic organs using Doppler technology. It helps detect abnormalities in blood flow patterns associated with conditions such as ovarian torsion or pelvic inflammatory disease.

3D/4D Pelvic Ultrasound: Provides detailed, high-resolution 3D or 4D images of pelvic organs. This advanced imaging is beneficial for evaluating complex anatomical structures, identifying abnormalities, and monitoring foetal development during pregnancy.

Follicular Monitoring Ultrasound: Monitors ovarian follicle development and helps fertility specialists determine the optimal time for fertility treatments like ovulation induction or assisted reproductive techniques.

Sonohysterography (SIS): Involves injecting saline solution into the uterus during ultrasound to visualise the uterine cavity. It helps diagnose conditions such as polyps, fibroids, or congenital uterine anomalies contributing to infertility or abnormal bleeding.

Ovarian Cysts: Pelvic ultrasound not only detects ovarian cysts but also assesses their characteristics (such as size, location, and type—simple or complex). This helps in determining whether the cyst is likely benign or requires further evaluation or intervention.

Uterine Fibroids: Ultrasound helps quantify the size, number, and location of fibroids within the uterus. This information is crucial for guiding treatment decisions, such as whether conservative management, medication, or surgical intervention (like myomectomy or hysterectomy) is appropriate.

Endometriosis: While pelvic ultrasound alone may not definitively diagnose endometriosis, it can visualise ovarian endometriomas (chocolate cysts) and help identify pelvic adhesions or nodules suggestive of the condition. This aids in planning further diagnostic or therapeutic procedures, such as laparoscopy.

Adenomyosis: Pelvic ultrasound is effective in diagnosing adenomyosis by showing diffuse thickening of the uterine muscle and small cysts (microcysts) within the myometrium. It assists in distinguishing adenomyosis from other uterine conditions causing similar symptoms.

Pelvic Inflammatory Disease (PID): Ultrasound can detect fluid collections (abscesses) and thickened, fluid-filled fallopian tubes indicative of PID. Early detection through ultrasound helps in prompt initiation of antibiotic therapy to prevent complications such as infertility or chronic pelvic pain.

Ectopic Pregnancy: Ultrasound plays a critical role in diagnosing ectopic pregnancy by visualising the pregnancy outside the uterus, usually in the fallopian tubes. Early detection is crucial to prevent rupture and life-threatening complications.

Polycystic Ovary Syndrome (PCOS): Beyond confirming the presence of ovarian cysts, pelvic ultrasound evaluates ovarian volume and the presence of multiple small follicles (follicular excess). This assists in diagnosing PCOS and guiding management strategies to improve menstrual regularity and fertility.

Pelvic Congestion Syndrome: Ultrasound identifies dilated pelvic veins, helping diagnose pelvic congestion syndrome, a condition causing chronic pelvic pain exacerbated by prolonged standing or sitting. It guides treatment options such as embolisation or hormonal therapies.

Pelvic Masses Or Tumours: Ultrasound characterises pelvic masses, distinguishing between benign conditions (such as fibroids or ovarian cysts) and malignant tumours. It guides further diagnostic procedures, such as MRI or biopsy, and helps in planning surgical interventions or oncological treatments.

Uterine Anomalies: Pelvic ultrasound detects congenital uterine anomalies (like septate or bicornuate uterus), providing essential information for managing fertility challenges and guiding obstetric care during pregnancy.

Infertility Evaluation: Ultrasound assesses pelvic anatomy, ovarian function, and follicular development to identify potential causes of infertility. It aids in monitoring ovarian response to fertility treatments and guiding assisted reproductive techniques.

Menstrual Irregularities: By visualising the endometrial thickness and texture, ultrasound helps in diagnosing causes of abnormal uterine bleeding, such as endometrial polyps or hyperplasia. This guides appropriate management, including hormonal therapy or surgical intervention.

Individuals With Pelvic Pain: Individuals experiencing persistent or unexplained pelvic pain may undergo pelvic ultrasound to investigate potential causes such as ovarian cysts, endometriosis, or pelvic inflammatory disease.

Patients With Menstrual Irregularities: Patients presenting with irregular menstrual cycles, heavy periods (menorrhagia), or postmenopausal bleeding may require pelvic ultrasound to assess the uterus and ovaries for conditions affecting menstrual health.

Women Undergoing Fertility Assessment: Women undergoing fertility evaluation undergo pelvic ultrasounds to check ovarian follicles, assess uterine health, and identify any structural abnormalities that could impact fertility.

Patients With Suspected Ovarian/Uterine Abnormalities: Patients with symptoms or findings suggestive of ovarian cysts, uterine fibroids, or other pelvic masses may undergo pelvic ultrasound to characterise the size, location, and nature of the abnormality.

Individuals Undergoing Routine Gynaecological Examinations: Individuals undergoing routine gynaecological examinations, especially those at risk for gynaecological conditions or with a family history of ovarian or uterine cancer, may have pelvic ultrasound as part of preventive care or screening.

Pregnant Women Undergoing Routine Prenatal Monitoring: Pregnant women undergo pelvic ultrasounds as part of routine prenatal care to monitor foetal growth, assess placental health, and ensure normal development.

Women With Previous Gynaecological Surgeries: Women with a history of gynaecological surgeries such as hysterectomy/myomectomy get ultrasounds to check for post-surgical complications or recurrence of conditions.

Patients With Pelvic Inflammatory Symptoms: Patients presenting with symptoms of pelvic inflammatory disease (PID), such as pelvic pain, fever, or abnormal vaginal discharge, may require pelvic ultrasound to evaluate the fallopian tubes and surrounding pelvic organs for signs of infection or inflammation.

Preparation: The patient may be asked to change into a gown and empty their bladder before the procedure to improve visibility of pelvic structures.

Positioning: The patient lies on an examination table, usually on their back. Sometimes, for a transvaginal ultrasound, the patient may be asked to lie on their back with knees bent or in a side-lying position.

Gel Application: A clear gel is applied to the abdomen (for transabdominal ultrasound) or to a transducer probe (for transvaginal ultrasound). This gel helps transmit sound waves and improves the quality of the ultrasound images.

Transducer Placement: For transabdominal ultrasound, the transducer is moved over the lower abdomen, emitting and receiving sound waves that bounce off pelvic organs and tissues. For transvaginal ultrasound, a lubricated transducer probe is inserted into the vagina to obtain close-up images of pelvic organs.

Image Capture: The ultrasound technologist or radiologist moves the transducer to different positions to capture images of the uterus, ovaries, fallopian tubes, bladder, and other pelvic structures. They may also use Doppler ultrasound to assess blood flow in the pelvic organs if needed.

Interpretation: Real-time images appear on a monitor, allowing the technologist or radiologist to analyse and interpret the ultrasound findings immediately.

Documentation: The findings are documented in a report and shared with the patient’s healthcare provider, who will discuss the results and any necessary follow-up steps with the patient.

Post-procedure: After the procedure, the patient can usually resume normal activities immediately. The gel is wiped off, and there are typically no lasting effects from the ultrasound.

Uterus: Normal test results indicate that the uterus appears normal in size, shape, and position. There are no abnormalities such as fibroids, polyps, or masses. The endometrial lining is of normal thickness for the patient's menstrual cycle phase or menopausal status, suggesting no signs of hyperplasia, polyps, or other abnormalities. For example, a normal endometrial thickness ranges from 2-4 mm post-menopause to up to 16mm during the proliferative phase of the menstrual cycle.

Ovaries: Normal results for the ovaries mean they are of typical size and shape, with no cysts, masses, or irregularities. During reproductive years, normal ovarian size ranges from 2.5 to 5 cm in length, 1.5 to 3 cm in width, and 0.6 to 2.2 cm in height. Normal follicles may be visible, corresponding to the stage of the menstrual cycle, typically ranging from 2 to 10 mm in diameter. In postmenopausal women, the ovaries are typically smaller, with a volume less than 20 cm³, and no active follicles.

Fallopian Tubes: Normal test results indicate that the fallopian tubes are not dilated or enlarged. Fallopian tubes are usually not visible on a normal ultrasound unless they are dilated or filled with fluid, which could indicate a problem such as hydrosalpinx.

Bladder: Normal results for the bladder show it is of typical size and shape, with no signs of masses, stones, or abnormalities in the bladder wall. The bladder should appear well-defined without irregularities. A normal bladder wall thickness is generally less than 3 mm when distended and less than 5 mm when empty.

Other Pelvic Structures: A normal ultrasound shows no abnormal masses, free fluid, or other irregularities in the pelvic cavity. The surrounding tissues and structures are unremarkable and appear healthy. There should be no evidence of fluid accumulation in the pelvic cavity.

Blood Flow: If Doppler ultrasound is used, normal results show typical blood flow patterns in pelvic organs, indicating no vascular abnormalities/blockages. Blood flow to the uterus, ovaries, and other pelvic structures appears normal. For example, normal uterine artery resistance index values typically range from 0.5 to 0.8.

Uterus: Abnormal results may reveal uterine conditions such as fibroids (benign growths), polyps (small, benign growths on the lining of the uterus), or structural anomalies like a bicornuate or septate uterus. An abnormally thickened endometrial lining might suggest endometrial hyperplasia or cancer, especially in postmenopausal women. Endometrial thickness greater than 16 mm during the reproductive phase or more than 4 mm in postmenopausal women without hormone therapy may raise concerns.

Ovaries: Abnormal results can identify ovarian cysts, which can be functional (e.g., follicular cysts) or pathological (e.g., dermoid cysts, endometriomas). Large cysts or complex cysts with solid areas and septations may require further evaluation to rule out malignancy. Polycystic ovaries, seen in polycystic ovary syndrome (PCOS), appear enlarged with multiple small follicles (more than 20 follicles per ovary). Ovarian masses or tumours might also be detected.

Fallopian Tubes: Abnormal findings in the fallopian tubes can indicate hydrosalpinx (dilated tubes filled with fluid), which may result from pelvic inflammatory disease (PID) or previous infections. This condition can cause infertility or chronic pelvic pain. Ectopic pregnancies, where a fertilised egg implants outside the uterus, are also a critical abnormal finding in the fallopian tubes.

Bladder: Abnormal bladder results might show masses or tumours, bladder stones, or thickening of the bladder wall, which could indicate inflammation, infection, or bladder cancer. A bladder wall thickness greater than 3 mm when distended or 5 mm when empty could be concerning.

Other Pelvic Structures: Abnormalities include the presence of free fluid in the pelvic cavity, which occur due to ruptured cysts, ectopic pregnancy, or infection. Pelvic inflammatory disease is identified by the presence of thickened fallopian tubes, abscesses, or fluid collections. Masses in adjacent structures can also be detected.

Blood Flow: Abnormal Doppler ultrasound results can indicate issues with blood flow to pelvic organs. Increased resistance or abnormal blood flow patterns in the uterine or ovarian arteries suggest conditions like ovarian torsion (twisting of the ovary), which is an emergency, or tumours with increased vascularity. Uterine artery resistance index values significantly outside the normal range of 0.5 to 0.8 could indicate pathology.

Discomfort: Transabdominal ultrasound may cause discomfort due to pressure on a full bladder, while transvaginal ultrasound can cause mild discomfort or pressure when the probe is inserted.

No Radiation Exposure: Unlike other imaging techniques such as X-rays or CT scans, pelvis ultrasound does not use ionising radiation, making it a safer option, especially for pregnant women and young patients.

Allergic Reactions: Although very rare, some patients might experience an allergic reaction to the ultrasound gel used during the procedure. The gel is generally hypoallergenic, but it’s important to inform the healthcare provider if there is a known sensitivity to such products.

False Positives/Negatives: Like any diagnostic test, there is a small risk of false positive or false negative results meaning misinterpretation of a problem which does not exist or a problem might be missed entirely.

Limited Scope: Ultrasound may not detect all types of abnormalities, especially very small lesions or conditions outside the pelvic organs; field of view. In such cases, further imaging like MRI or CT scans might be necessary for a comprehensive evaluation.

Patient-Specific Factors: Certain factors such as obesity, excessive bowel gas, or prior pelvic surgeries can affect the quality of the ultrasound images. These factors make it more difficult to obtain clear results.

Practice Kegel Exercises: Kegel exercises strengthen your pelvic floor muscles. These exercises involve contracting and relaxing the muscles used to stop urine flow. Aim to do three sets of 10-15 repetitions daily.

Maintain A Healthy Weight: Being overweight puts extra pressure on the pelvic floor muscles, which can lead to weakness and pelvic organ prolapse. Maintaining a healthy weight supports pelvic floor health.

Stay Hydrated & Eat A High-Fibre Diet: Prevent constipation by drinking plenty of water and eating a diet rich in fibre. Straining during bowel movements can weaken the pelvic floor muscles.

Avoid Heavy Lifting: Heavy lifting can strain the pelvic floor muscles. If you need to lift heavy objects, be sure to use proper techniques, such as bending your knees and keeping your back straight, to minimise strain.

Quit Smoking: Smoking can lead to chronic coughing, which puts stress on the pelvic floor muscles. Quitting smoking can help reduce coughing and protect your pelvic floor.

Practice Good Posture: Maintain good posture when sitting and standing to reduce strain on your pelvic floor muscles. Engage your core muscles to support your pelvic floor.

Exercise Regularly: Engage in regular activities like walking, swimming, and yoga to keep your body and pelvic floor muscles strong. Avoid high-impact exercises that may put excessive strain on the pelvic floor.

Avoid Prolonged Sitting: Sitting for long periods can weaken pelvic floor muscles. Take regular breaks to stand, stretch, and move around.

Manage Chronic Conditions: Conditions such as diabetes and respiratory issues can impact pelvic floor health. Properly managing these conditions can reduce their negative effects on the pelvic floor.

Seek Professional Advice: If you experience pelvic floor problems such as incontinence or pelvic pain, consult a healthcare provider. A therapist specialising in pelvic health can provide personalised treatment plans.

What Is A Pelvis Ultrasound?

Why Is A Pelvis Ultrasound Performed?

What Is The Difference Between A Pelvic Scan & Ultrasound?

Is A Pelvis Ultrasound Safe?

Does A Pelvis Ultrasound Hurt?

How Long Does The Procedure Take?

What Do Abnormal Results Mean?

Do I Need A Referral For A Pelvis Ultrasound?

Can A Pelvis Ultrasound Detect Cancer?

Can A Pelvis Ultrasound Be Done During Menstruation?

Can Men Undergo A Pelvis Ultrasound?

Is There A Difference Between ‘Pelvis’ & ‘Pelvic’?

What Is The Difference Between A Pelvis Ultrasound & Pelvic Ultrasound?

How Does A Pelvis Ultrasound Differ From Other Imaging Tests Like CT/MRI?

Will A Pelvis Ultrasound Interfere With Medical Devices Implanted?

Can Children Undergo A Pelvis Ultrasound?

Can A Pelvis Ultrasound Be Performed After Pelvic Surgery?

What Is The Difference Between A 2D, 3D & 4D Pelvis Ultrasound?

Can A Pelvis Ultrasound Detect Sexually Transmitted Infections (STIs)?